In December 2022, the FDA expanded the use of bivalent boosters to children between 6 months and 4 years old, either two months after they have completed their primary series of vaccinations (Moderna) or as the third dose in their primary series (Pfizer). Even so, some people have safety concerns and worry that people who’ve been vaccinated could transmit the virus. However, kids cannot get COVID-19 from someone who is vaccinated just because the vaccinated person got the shot (the vaccine itself does not cause recipients to shed the virus). But kids could get infected via exposure to a vaccinated person who has a breakthrough infection. Learn more about vaccine efficacy, breakthrough infections, boosters, and how they relate to how vaccinated people interact with unvaccinated children.
Breakthrough Infections
Vaccination has been very successful at reducing COVID-19 infection—and especially severe illness. However, as you think about your unvaccinated children, it’s important to remember that, while less likely, some vaccinated people will still get COVID-19. These infections in vaccinated people are called “breakthrough infections.” Breakthroughs can occur with vaccine-preventable diseases because vaccines are not 100% effective. If a vaccinated person has a breakthrough infection, it’s usually a milder case—but they may transmit the virus to others. This is why it’s so important to get everyone in your family vaccinated. “Breakthrough cases happen, and they are increasing in frequency, which is why I think it’s important for people to get boosters if they’re eligible,” says Kawsar Talaat, MD, associate professor of international health at the Johns Hopkins Bloomberg School of Public Health. “That will decrease the frequency of breakthrough cases and also decrease the risk of infection with Omicron,” a newer variant of the virus, Vaccination is about protecting yourself, but it’s also about protecting family and community members. It isn’t yet about lowering our guard and declaring the whole pandemic over.
You Can’t Get COVID-19 From the Vaccine
Amina Ahmed, MD, professor of pediatric infectious disease and immunology at Atrium Health Levine Children’s Hospital, explains that the Pfizer and Moderna vaccines are both of the mRNA variety. This type of vaccine uses chemical synthesis to reproduce a small portion of the virus. Since the vaccine contains no live virus, a person can neither catch COVID-19 nor spread the virus due to the injection. Dr. Ahmed explains that with the current vaccines, “There’s no live virus at all. It’s just genetic material” from the spike protein that surrounds the virus. These vaccines use the spike protein portion of the virus to prompt the body’s immune system to respond and create antibodies. The spike protein, found covering the surface of the actual SARS-CoV-2 virus, allows the virus to enter the human cells. So, if a vaccinated person is exposed to the actual virus, the immune system would recognize these spike proteins and mount a defense against the whole virus.
Boosters and Waning Immunity
According to the Centers for Disease Control and Prevention (CDC), vaccine protection wanes over time. The CDC recommends booster shots for everyone 5 and older who received their second COVID-19 vaccine dose at least five months ago. The exception is that children who were initially vaccinated with Moderna do not need boosters. While vaccines effectively prevent illness, especially severe illness and hospitalization, some vaccinated people, even after getting booster shots, will still get sick with breakthrough infections. However, these infections are usually less severe. “Certainly, those who are unvaccinated are more likely to be hospitalized and to get COVID in general,” says Talaat. “But we are seeing a lot of breakthroughs, and so if you’re in a hot spot, you should be pretty careful about having large gatherings where people are unmasked.” In addition to the possibility of breakthrough infections, it’s important to remember that it takes two weeks for your body to build up immunity after vaccination. That’s why people are not considered fully vaccinated until two weeks after their second dose. The same is true for added immunity from a booster. People who are immunocompromised may not as effectively build immunity from vaccination. Therefore, the CDC recommends they receive more frequent booster doses following their second dose.
How to Safely Spend Time With Family
While children have been less susceptible to severe COVID-19, the fact is the virus can be serious and even fatal in children. So, the CDC still recommends that everyone practice regular hand hygiene, social distance, and wear a mask in crowded, indoor spaces, particularly in places experiencing local outbreaks. To protect unvaccinated family members, including babies under 6 months old, the CDC recommends:
Get yourself and all eligible children and adults in the home vaccinated. Continue to have everyone in your family wear a mask indoors in public in areas of substantial or high transmission (some people may choose to mask regardless of transmission in their community).
Dr. Talaat suggests that people who spend time with unvaccinated children should try to be mindful of wearing their masks. “If you haven’t gotten a booster, get a booster if you’re eligible. And then once you are together, think about doing rapid testing just to make sure that everybody is negative.” The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. You can protect your unvaccinated kids by getting vaccinated and boosted and ensuring that everyone in your household 6 months old is fully vaccinated. In addition, make sure the people you spend time with are also vaccinated, and consider socializing in safer, well-ventilated, or outdoor spaces. If that’s not possible, wear masks.
